Cardiac ultrasound examination (Echocardiogram) is a non-invasive imaging diagnostic technique that uses high-frequency sound waves to produce real-time images of the heart's structure and function. It is primarily used to assess structural abnormalities, blood flow dynamics, and cardiac function. Common applications include diagnosing heart diseases, monitoring treatment effectiveness, or evaluating the causes of symptoms.
This procedure requires no anesthesia or incisions and can be performed in outpatient clinics or hospital wards, with an examination time of approximately 20-60 minutes. Its key advantage lies in the real-time display of cardiac dynamics, allowing precise analysis of ventricular contractility, valve function, and the presence of thrombi, making it an essential tool in cardiology clinical assessment.
Cardiac ultrasound mainly falls into three categories: transthoracic echocardiography (TTE) uses a probe on the chest wall; transesophageal echocardiography (TEE) involves inserting a probe into the esophagus for clearer images; stress echocardiography combines exercise or pharmacological agents to induce cardiac load followed by immediate scanning. Different types are suitable for different locations and carry varying risks.
The mechanism involves emitting sound waves from the ultrasound probe, which are reflected by tissues and converted into three-dimensional images by a computer. Doppler effect measures blood flow velocity and direction, while color Doppler visualizes turbulent or regurgitant blood flow, aiding in diagnosing valve stenosis or regurgitation.
Main indications include:
Other applications include suspected pericardial effusion, myocardial disease, or evaluating the function of artificial heart valves. Emergency uses often involve assessing ventricular wall motion abnormalities after suspected myocardial infarction or immediate diagnosis of suspected cardiac rupture.
For transthoracic ultrasound, the patient needs to expose the chest, with the technician applying gel and moving the probe to scan. For transesophageal ultrasound, local anesthesia is required before inserting the probe into the esophagus; this type requires fasting for 6 hours and cooperation with an anesthesiologist.
Dosage control mainly refers to the intensity of sound waves and scanning duration, with modern equipment having built-in safety parameters. When contrast agents are used to enhance imaging, strict adherence to drug concentration and injection speed is necessary. For example, when using acoustic enhancers (such as Definity), doses are calculated based on body weight.
This examination offers three core advantages: Real-time dynamic assessment: observing immediate changes in systolic and diastolic function; Non-invasive nature: avoiding radiation exposure, suitable for repeated follow-up; Multifaceted diagnosis: simultaneous assessment of anatomy, blood flow, and cardiac function.
The risk of transthoracic ultrasound is extremely low; potential discomfort includes skin irritation from probe pressure and allergic reactions to gel. Transesophageal ultrasound may cause laryngospasm or esophageal mucosal abrasions, with an incidence of about 0.5-1%.
When using acoustic enhancers, about 1-2% of patients may experience dizziness or rash, with very rare cases of allergic shock. Severe allergic reactions require immediate treatment with antihistamines or epinephrine.
Contraindications include:
Before the examination, remove metal objects from the chest area. Fasting for 8 hours is required before transesophageal procedures. Pregnant women should evaluate the necessity of the examination; although there is no clear evidence of harm from sound waves to the fetus, caution is recommended during early pregnancy.
This examination does not directly interact with other treatments or medications, but attention should be paid to:
The results may influence subsequent treatment decisions, such as identifying valve stenosis that may lead directly to surgical evaluation.
Multiple studies confirm that transthoracic echocardiography has a diagnostic accuracy of over 90% for structural abnormalities, while transesophageal echocardiography has a sensitivity of up to 95% for atrial septal defects or artificial valve function assessment. The 2020 European Society of Cardiology guidelines list it as the first-line examination for heart failure assessment.
Clinical evidence shows that combining strain imaging can detect myocardial ischemia early and accurately predict cardiac events. Large retrospective studies confirm high reproducibility for follow-up, making it suitable for monitoring treatment effectiveness.
Alternative examinations include:
Cardiac magnetic resonance imaging (CMR) provides more detailed tissue characterization but has longer scan times and higher costs. The choice of examination depends on the severity of clinical symptoms and suspected lesions.
Generally, no fasting or medication adjustment is required for a cardiac ultrasound. However, if a stress test (such as exercise-induced testing) is involved, the doctor may ask you to fast for 2 hours before the exam. If you have arrhythmia or hypertension, inform the medical staff beforehand for medication timing assessment.
Will the procedure cause pain or discomfort?Cardiac ultrasound is painless and non-invasive. It only involves applying gel on the chest and placing the probe, which may cause slight pressure sensation, but most patients tolerate it well. If breath-holding or posture changes are needed during the exam, staff will explain to reduce anxiety.
How long does it usually take to get the results?Initial results from a standard cardiac ultrasound can be obtained immediately after the exam, with detailed reports usually completed within 1 to 3 working days. If complex analysis such as 3D imaging or blood flow calculations is involved, additional time may be needed for specialist review.
Do pacemakers or metal implants affect the examination?Pacemakers, artificial valves, and other implants do not interfere with the results, but inform the staff before the exam. If the implant is magnetic, the technician may adjust the probe angle or use special techniques to ensure image clarity. This information helps in planning the procedure.
Are there differences in accuracy among different types of cardiac ultrasound?Standard static echocardiography provides high accuracy for ventricular function assessment, but for dynamic blood flow observation (such as regurgitation), Doppler techniques may be used. Intravascular ultrasound (ICE) is more invasive but offers more precise measurement of stenosis. The physician will choose the most appropriate type based on symptom severity to ensure accurate diagnosis.
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